I know this quote is attributed to Hippocrates but I first heard it from my Mom. My mom, Dr. Ernestine Berg became a doctor back when you needed courage to enter that world as a woman. Quiet and strong,
this woman of faith raised six children after my father's early death from
leukemia. Being very well read, Mom always had great quip to share. This was just one: "Seldom cure, often treat, comfort always." As a surgeon I never really liked this quote- surgery is fun because, actually, despite the quote, you can often cure.
Maybe it's for this reason that I was depressed this week after operating on beautiful eight-year-old girl. Her loving and obviously very caring father had brought her from far away to our hospital because he was concerned about a swelling in her abdomen; now she had quit eating and was losing weight. On examination she had an obvious large mass in the abdomen but mobile enough to suggest attempting its removal. I hoped. With our limited technology here (no CT, no pathology, minimal labs) the only thing left to do is try to remove it.
At operation she had an obviously metastatic malignancy of some type. All I could do was simply relieve the obstruction and close her abdomen. It's depressing to me, coming to terms with my inability to do anything to help such a lovely little girl. In fact, all I did was give this girl a big painful incision! Sharing the burden of grief with her father was next.
I was able to clearly communicate to him the situation and, to my surprise,
the father seemed relieved and extremely grateful.
As I walked slowly home in the waning light of that evening I had felt a failure.
And then it occurred to me that from the father's perspective he had done all that he could and, so had I. He could now understand the situation. For him, not knowing and not trying may have been worse than the truth. Now that he had some clarity, he was relieved and even somehow comforted.
It was then that my Mom's quote came to mind: "comfort always." Maybe I had done more than I thought...
Thanks Mom!
Oh honey, I wish I was there to meet them and to be able to talk with you at night about your cases, etc. I miss you. I agree with this man's perspective - you DID bring comfort to them, I'm sure of it! I love you, and I am so proud of you. See you soon. Maybe I can meet them, yet. I will bring her a beanie baby! <3
ReplyDeleteTim - all treatment is, ultimately, palliative, and in your careful approach to her operation you DID accomplish a great deal. You gave her family answers, you used your surgical skills to come to the best decision, and you will have made her remaining time here on earth more comfortable. I'm not just being a spin nurse when I say, this counts as a "success," although it's one that weighs very heavy on the heart. I'll try to keep you company while you keep her comfortable.
ReplyDeleteTim - when it comes down to it, all medical treatment is palliative, and in this case you have done much to alleviate suffering and provide care. As you say, you have given the family answers, in your thoughtful approach to her surgery you first did no harm, then came up with a workable solution to her most problematic symptom, and you continue to use your brain and skills to meet her needs. I'm not just being a spin nurse when I say that this counts as a "success," although it's one that definitely weighs heavy on the heart. I will keep you company while you keep her comfortable, and we will find comfort in knowing that we stayed with it.
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